Issues of conservative treatment of patients with flatfoot

Abstract

Flatfoot is the most common foot disease, the prevalence of which is 30-70% according to many authors. Planovalgus foot deformity asymptomatically existing for a long time can further lead to pain syndrome and limping, sensitivity disorders, trophic disorders, limitation of foot joints mobility, development of arthritic changes with corresponding progression of the function impairment. Timely initiation of treatment, complex pathogenetic and symptomatic therapy as well as strict adherence to the doctor's recommendations help to achieve maximum effect. The aims of treatment of patients with flatfoot are posture stabilization and support of overloaded zones of the plantar surface, improvement of supply of the foot and musculoskeletal apparatus, as well as foot joints, and reduction of pain syndrome. Despite the prevalence of pathology, as well as a wide range of methods of treatment and rehabilitation, conservative treatment does not always lead to a positive result and the problem remains unresolved. This literature review describes the main directions of conservative therapy of patients with flatfoot from the view of evidence-based medicine. The data on the use of special ortheses and orthopedic shoes for correcting the foot deformities are discussed with a description of possible complications. The main forms of exercise therapy used to stabilize the foot muscles tonus, are analyzed. The application of physiotherapeutic factors aimed at improving trophic and blood supply of tissues, as well as strengthening of the musculoskeletal apparatus of the lower legs and feet, is described. Data on the use of complex conservative treatment of patients with flatfoot are presented. The article also focuses on the use of drug therapy as part of the complex treatment.